Acupuncture is used in Korea to reduce tremor.

Essential Tremor and CAM, Part I: Acupuncture and Pharmacopuncture

I thought it would be interesting to do a small series of blogs on complementary and alternative medicine (CAM) treatments for essential tremor (ET). Standard medicine (also called Western, allopathic, mainstream or conventional medicine) was slow to embrace CAM until roughly the last four decades, and then the pace accelerated quickly. Complementary medicine refers to nonstandard treatments that are used together with standard medicine in hopes of boosting treatment effectiveness or reducing conventional side effects. Alternative medicine means treatments that are used exclusively instead of standard medicine. CAM can include healing modalities from many different cultures and even past eras. For example, Chinese herbs, acupuncture, aromatherapy, homeopathy, hypnosis, biofeedback, vitamins and supplements, etc. are among the wide array of products and methods that are implemented to facilitate healing and wellness.

I thought I would begin with two Korean treatments for ET: acupuncture and pharmacopuncture. I found a 2013 published journal article by Jeong & Sun that reported the cases of three elderly women whose ET was improved with a combination of these two treatments.i

Sa-Am Five Element Acupuncture
Acupuncture involves the insertion of very fine needles into points in the body that correspond to the flow of energy along certain lines or channels called meridians. There are many schools of acupuncture, and Sa-Am was a master physician in Korea about 400 years ago so his particular method was used. In his philosophy, there are 12 mind/body meridians, and each one there are 60 conduits that concentrate the particular characteristics of the five elements: metal, water, earth, wood and fireii. A specially trained practitioner knows where to insert the needles to intervene in the disease and facilitate healing.

Hwangyeonhaedoktang Pharmacopuncture
Pharmacopuncture uses acupuncture principles, but instead of a fine needle, a hypodermic syringe with a thin, short needle is inserted at the desired point, and a small amount of an herbal (or other natural ingredient) distillate is injected into the point. This enhances the therapeutic effect of acupuncture, and it is believed that progress is more rapid than with acupuncture alone. The hwangyeonhaedoktang method is one type of pharmacopuncture called Eight Principles Pharmacopuncture, or (EPP). Studies suggest that pharmacopuncture is most commonly used in patients with musculoskeletal problems such as arthritis, back pain, shoulder pain, leg spasticity, etc. but it has also been used with nervous disorders and to relieve cancer pain or chemotherapy side effects. The most common ingredient reported in the literature is bee venom.

In the Jeong & Sun study, the three cases were Korean women in their 70s and 80s. All of them received the combined acupuncture/pharmacopuncture treatment. When the degree of tremor was evaluated before and after (using a numeric scale) all of them experienced improvement of their symptoms. If ET recurred, the same treatment brought the same degree of improvement.

Pharmacopuncture is mostly practiced in Korea. Aside from this study, I could not find other evidence of ET treatment using this method. However, I came across a 2010 Chinese study of 60 ET patients who were randomized into two groups of 30.iii One group received oral medication alone (Propranolol) while the other group received the same dosage and also had acupuncture. The tremor score was better in the second group, indicating that acupuncture had a successful complementary effect.

The Sperling Medical Group supports the use of CAM for ET and other conditions, but with this caution: do your research at to locate published clinical studies, and make sure the practitioner is licensed or certified, and has a solid reputation.

For ET that is not responding to other therapies, our Group offers MRI-guided Focused Ultrasound (MRgFUS) for the noninvasive treatment of ET at its source in the brain.

iJeong JJ, Sun SH. Sa-am five-element acupuncture and hwangyeonhaedoktang pharmacopuncture treatment for essential tremor: three case reports. J Pharmacopuncture. 2013 Dec;16(4):49-53. doi: 10.3831/KPI.2013.16.022.
iiYoon, Simon. “SaAm Five Element Acupuncture.”
iiiSui KM, Li X. Clinical observation on acupuncture combined with medication for treatment of essential tremor. Zhongguo Zhen Jiu. 2010 Feb;30(2):107-9.

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Neurosurgery Associates.